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Left Ventricular Apical Aortic Conduit
Suhny Abbara, MD, FACR, FSCCT
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KEY FACTS

  • Imaging

    • Pathology

      • Clinical Issues

        TERMINOLOGY

        • Synonyms

          • Apical aortic conduit; apicoaortic conduit
          • Apicoaortic bypass
        • Definitions

          • Extraanatomic valved graft connecting left ventricular apex to descending thoracic aorta
            • Typically used in patients with severe aortic stenosis and porcelain aorta or other condition precluding median sternotomy (e.g., retrosternal coronary grafts)
            • Complex congenital left ventricular outflow tract anomalies ± hypoplastic ascending aorta and arch

        IMAGING

        • General Features

          • Imaging Recommendations

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      CLINICAL ISSUES

                      • Demographics

                        • Natural History & Prognosis

                          • Treatment

                            DIAGNOSTIC CHECKLIST

                            • Consider

                              • Image Interpretation Pearls

                                Selected References

                                1. Perlman GY et al: First transcatheter valve-in-valve implantation in an apicoaortic conduit. Catheter Cardiovasc Interv. 91(7):E86-9, 2018
                                2. Jneid H et al: Transcatheter aortic valve replacement as a treatment for late apicoaortic conduit obstruction in a patient with severe aortic stenosis. Circulation. 127(11):e491-4, 2013
                                3. Domoto S et al: Apicoaortic bypass for a patient with structural valve deterioration of a 19 mm bioprosthetic valve. Interact Cardiovasc Thorac Surg. 14(1):105-7, 2012
                                4. Filsoufi F et al: Apicoaortic conduit. Semin Thorac Cardiovasc Surg. 24(3):202-5, 2012
                                5. Nance JW et al: Apicoaortic conduits: indications, complications, and imaging techniques. J Thorac Imaging. 27(3):141-7, 2012
                                6. Elmistekawy E et al: Apico-aortic conduit for severe aortic stenosis: technique, applications, and systematic review. J Saudi Heart Assoc. 22(4):187-94, 2010
                                7. Faletra F et al: Multidetector computed tomography image of apical left ventricular descending aorta conduit. Heart. 93(4):449, 2007
                                8. Chiu KM et al: Images in cardiovascular medicine. Left ventricle apical conduit to bilateral subclavian artery in a patient with porcelain aorta and aortic stenosis. Circulation. 113(9):e388-9, 2006
                                9. Brown JW et al: Long-term results of apical aortic conduits in children with complex left ventricular outflow tract obstruction. Ann Thorac Surg. 80(6):2301-8, 2005
                                10. Freeman LJ et al: The longest functioning apical left ventricular to descending aortic valve conduit. Ann Thorac Surg. 79(4):1420, 2005
                                11. Fogel MA et al: Evaluation and follow-up of patients with left ventricular apical to aortic conduits with 2D and 3D magnetic resonance imaging and Doppler echocardiography: a new look at an old operation. Am Heart J. 141(4):630-6, 2001
                                12. Renzulli A et al: Long-term results of apico-aortic valved conduit for severe idiopathic hypertrophic subaortic stenosis. Tex Heart Inst J. 27(1):24-8, 2000
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Imaging

                                  • Pathology

                                    • Clinical Issues

                                      TERMINOLOGY

                                      • Synonyms

                                        • Apical aortic conduit; apicoaortic conduit
                                        • Apicoaortic bypass
                                      • Definitions

                                        • Extraanatomic valved graft connecting left ventricular apex to descending thoracic aorta
                                          • Typically used in patients with severe aortic stenosis and porcelain aorta or other condition precluding median sternotomy (e.g., retrosternal coronary grafts)
                                          • Complex congenital left ventricular outflow tract anomalies ± hypoplastic ascending aorta and arch

                                      IMAGING

                                      • General Features

                                        • Imaging Recommendations

                                          • Radiographic Findings

                                            • CT Findings

                                              • MR Findings

                                                DIFFERENTIAL DIAGNOSIS

                                                  PATHOLOGY

                                                  • General Features

                                                    CLINICAL ISSUES

                                                    • Demographics

                                                      • Natural History & Prognosis

                                                        • Treatment

                                                          DIAGNOSTIC CHECKLIST

                                                          • Consider

                                                            • Image Interpretation Pearls

                                                              Selected References

                                                              1. Perlman GY et al: First transcatheter valve-in-valve implantation in an apicoaortic conduit. Catheter Cardiovasc Interv. 91(7):E86-9, 2018
                                                              2. Jneid H et al: Transcatheter aortic valve replacement as a treatment for late apicoaortic conduit obstruction in a patient with severe aortic stenosis. Circulation. 127(11):e491-4, 2013
                                                              3. Domoto S et al: Apicoaortic bypass for a patient with structural valve deterioration of a 19 mm bioprosthetic valve. Interact Cardiovasc Thorac Surg. 14(1):105-7, 2012
                                                              4. Filsoufi F et al: Apicoaortic conduit. Semin Thorac Cardiovasc Surg. 24(3):202-5, 2012
                                                              5. Nance JW et al: Apicoaortic conduits: indications, complications, and imaging techniques. J Thorac Imaging. 27(3):141-7, 2012
                                                              6. Elmistekawy E et al: Apico-aortic conduit for severe aortic stenosis: technique, applications, and systematic review. J Saudi Heart Assoc. 22(4):187-94, 2010
                                                              7. Faletra F et al: Multidetector computed tomography image of apical left ventricular descending aorta conduit. Heart. 93(4):449, 2007
                                                              8. Chiu KM et al: Images in cardiovascular medicine. Left ventricle apical conduit to bilateral subclavian artery in a patient with porcelain aorta and aortic stenosis. Circulation. 113(9):e388-9, 2006
                                                              9. Brown JW et al: Long-term results of apical aortic conduits in children with complex left ventricular outflow tract obstruction. Ann Thorac Surg. 80(6):2301-8, 2005
                                                              10. Freeman LJ et al: The longest functioning apical left ventricular to descending aortic valve conduit. Ann Thorac Surg. 79(4):1420, 2005
                                                              11. Fogel MA et al: Evaluation and follow-up of patients with left ventricular apical to aortic conduits with 2D and 3D magnetic resonance imaging and Doppler echocardiography: a new look at an old operation. Am Heart J. 141(4):630-6, 2001
                                                              12. Renzulli A et al: Long-term results of apico-aortic valved conduit for severe idiopathic hypertrophic subaortic stenosis. Tex Heart Inst J. 27(1):24-8, 2000